Dilated cardiomyopathy and sudden death resulting from constitutive activation of protein kinase a

Circ Res. 2001 Nov 23;89(11):997-1004. doi: 10.1161/hh2301.100003.

Abstract

beta-Adrenergic receptor (betaAR) signaling, which elevates intracellular cAMP and enhances cardiac contractility, is severely impaired in the failing heart. Protein kinase A (PKA) is activated by cAMP, but the long-term physiological effect of PKA activation on cardiac function is unclear. To investigate the consequences of chronic cardiac PKA activation in the absence of upstream events associated with betaAR signaling, we generated transgenic mice that expressed the catalytic subunit of PKA in the heart. These mice developed dilated cardiomyopathy with reduced cardiac contractility, arrhythmias, and susceptibility to sudden death. As seen in human heart failure, these abnormalities correlated with PKA-mediated hyperphosphorylation of the cardiac ryanodine receptor/Ca(2+)-release channel, which enhances Ca(2+) release from the sarcoplasmic reticulum, and phospholamban, which regulates the sarcoplasmic reticulum Ca(2+)-ATPase. These findings demonstrate a specific role for PKA in the pathogenesis of heart failure, independent of more proximal events in betaAR signaling, and support the notion that PKA activity is involved in the adverse effects of chronic betaAR signaling.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Animals
  • Calcium-Binding Proteins / metabolism
  • Cardiomyopathy, Dilated / enzymology
  • Cardiomyopathy, Dilated / etiology*
  • Cardiomyopathy, Dilated / metabolism
  • Cyclic AMP-Dependent Protein Kinases / genetics
  • Cyclic AMP-Dependent Protein Kinases / metabolism*
  • Cyclic AMP-Dependent Protein Kinases / physiology*
  • Death, Sudden, Cardiac / etiology*
  • Enzyme Activation
  • Humans
  • Mice
  • Mice, Transgenic
  • Myocardial Contraction
  • Myosin Heavy Chains / genetics
  • Phosphorylation
  • Ryanodine Receptor Calcium Release Channel / metabolism

Substances

  • Calcium-Binding Proteins
  • Ryanodine Receptor Calcium Release Channel
  • phospholamban
  • Cyclic AMP-Dependent Protein Kinases
  • Myosin Heavy Chains